UPMC offers state-of-the-art focused ultrasound (FUS) treatments through the UPMC Center for Image-Guided Neurosurgery (CIGNS), using the ExAblate Neuro system, first introduced to western Pennsylvania at UPMC Presbyterian in 2025. The CIGNS is an established world-renowned leader in minimally invasive neurosurgery for the treatment of a variety of neurologic conditions.
Focused ultrasound is an innovative, non-invasive technology that uses precisely targeted sound waves to treat deep areas of the brain without the need for surgery or radiation. Depending on the frequency used, FUS can either generate heat to treat conditions such as essential tremor and tremor-dominant Parkinson’s disease or create mechanical effects that temporarily open the blood-brain barrier. This latter approach is currently under investigation to improve the delivery of medication for conditions such as brain tumors, epilepsy and Alzheimer’s disease.
FUS treatments are guided by real-time MRI imaging, allowing for submillimeter precision and ongoing monitoring during the procedure. Because it is incisionless, focused ultrasound offers patients a faster recovery, fewer complications, and minimal side effects compared to traditional surgical approaches. Many patients with essential tremor or Parkinson’s disease experience significant tremor reduction immediately after treatment.
At the University of Pittsburgh, focused ultrasound is part of a comprehensive, patient-centered program led by a highly specialized multidisciplinary team. Each patient is carefully evaluated by experts from multiple fields—including neurosurgery, movement disorders, epilepsy and radiosurgery—to determine the safest and most effective treatment path based on their unique clinical needs.
The program is co-directed by Costas Hadjipanayis, MD, PhD, director of the UPMC Center for Image-Guided Neurosurgery and Jorge A. González-Martínez, MD, PhD, director of the UPMC Epilepsy and Functional Neurosurgery Program.
Dr. González-Martínez is internationally recognized for his pioneering work in functional neurosurgery and epilepsy, including advanced techniques such as stereo-electroencephalography (SEEG), SEEG-guided laser ablation, and robotic-assisted surgeries. He is actively expanding the use of focused ultrasound for patients with neurological conditions including epilepsy, addiction and psychiatric disorders through upcoming clinical trials.
Dr. Hadjipanayis is a leader in minimally invasive therapies for malignant brain tumors. His groundbreaking work includes the first use of 5-ALA (Gleolan) in the U.S. for fluorescence-guided glioma surgery, and the first intraoperative photodynamic therapy (PDT) for glioblastoma. He is currently leading and developing investigational studies that combine focused ultrasound with novel therapeutic agents to enhance treatment for difficult-to-reach tumors such as glioblastoma, brain metastases, and DIPG/DMG tumors.
The focused ultrasound program at the CIGNS is integrated into UPMC’s renowned Movement Disorders and Epilepsy Programs, which are among the few in the country to offer the full spectrum of treatment modalities—including medication management, deep brain stimulation, laser therapy, radiosurgery, botulinum toxin therapy and focused ultrasound. This breadth of options allows our team to provide personalized counseling and expert care, built on decades of experience treating a wide range of complex neurological conditions.
The multidisciplinary team with the UPMC focus ultrasound program includes Ajay Niranjan, MD; radiosurgery specialist with the Department of Neurological Surgery; Houman Homayoun, MD, Valerie Suski, DO, Sarah Berman, MD, PhD, movement disorder specialists with the Department of Neurology; and Thunder Aung, MD, and Alexandra Urban, MD, epilepsy specialists with the the Department of Neurology.
Every patient referred for focused ultrasound undergoes a comprehensive, multidisciplinary evaluation, including an assessment of their medical history, condition, and overall health. The team then works together to determine the best treatment plan tailored specifically to each patient’s needs, always prioritizing safety and long-term outcomes.
For more information on the UPMC focus ultrasound program, or to schedule a consultation, please contact Theodora Constantine at Constantinet@upmc.edu or Becky Miller at millrx@upmc.edu.